After defunding Obamacare, then what?

The Tea Party is gung ho about defunding Obamacare, making it the No. 1 goal of the new year.

Trouble is, I keep reading and hearing from people who complain about runaway health care costs for their families. The problem is not going to go away. This particularly hurts self-employed individuals, many of them from here.

I also find it ironic that many of the people who want to defund Obamacare have a government funded medical plan, either as a retiree or dependent of a government worker. In short, they “have theirs.”

Affordable health care would really help stimulate our economy.

So what their solution? It sounds like more of the same to me: The party of “no.”

Meanwhile, I hope Jerry Brown will tackle the issue in California while the politicans in Washington merely begin positioning themselves for the next Presidential election. It’s enough to make you sick.

Author: jeffpelline

Jeff Pelline is a veteran editor and award-winning journalist - in print and online. He is publisher of Sierra FoodWineArt magazine and its website SierraCulture.com. Jeff covered business and technology for The San Francisco Chronicle for 12 years, and he was a founding editor and Editor of CNET News for eight years, among other positions. Jeff has a bachelor's degree from UC Berkeley and a master's from Northwestern University. His hobbies include sailing, swimming, and trout fishing in the Sierra.

57 thoughts on “After defunding Obamacare, then what?”

  1. I would suggest that all insurance, medicare and medical care recipients in general look at the amazing stuff that’s being implemented in a huge service to SAVINGS to the patient and to the deficit– including the 80/20 rules and assisted living and preventative care it has implemented as of Jan. 1st of this year. At least 10 medicare rules address holding down costs and lowering prescription costs for those stuck in the donut hole by 50%…and only limit those who make over 170,000.00 as a couple (essentially double dippers) or 85,000.00 and it increases, by 10% on either end those doctors salaries choosing to practice in RURAL areas AND an extra 10% to those physicians re: prescriptions. The tea people have either been lied to or are carrying water for big pharma, and specialists. That 10% increase for rural areas INCLUDES surgeons who want to come work! Smart is the new Rich guys…check it out…Kate Hancock

  2. It would be nice if Jerry Brown picked up the health care ball where Obama and the democrats fumbled it. I hope for the day when I can raise my hands to the sky celebrating a TOUCHDOWN!

  3. In the end, it probably doesn’t matter what the House does. It will depend on the lawsuits slowly making their way to the top. Obamacare will live or die from the decision of one man, Anthony Kennedy. We already know how the others will vote.

    1. “Obamacare will live or die from the decision of one man, Anthony Kennedy.”

      Meanwhile, in other news, countries around the globe revel in the USA’s predictable descent into being a Third World country or a Banana Republic (choose one) because the Civil War never ended. How sad.

  4. CA legislatures have passed a type of single payer multiple times only to see the bill vetoed. Lets push our legislators to pass it again.

    Hopefully Jerry Brown will sign it into law.

    There is a rally on January 10th for Health Care for All in California.

    Sacramento

    At 11:15 a.m. supporters will march from the Embassy Suites to the north steps of the Capitol for a rally at 12:30 p.m.

    For information call Mindy at (530) 273-3033 or e-mail mindy@bagglady.com

  5. Also, California Health Professional Student Alliance (CAHPSA) and Physicians for a National Health Program (PNHP) California, are pitching this as a two-day event (Sunday and Monday, January 9th AND 10th), here:

    http://2011lobbyday.eventbrite.com/

    And here’s some promotional text from the Pace and Freedom Party website:

    The following information is from Single Payer Now chair Don Bechler.

    2011 offers a new opportunity to enact REAL health care reform in California, and show the rest of the country how to provide health care for everyone while saving individuals, employers and the State of CA millions of dollars. Senator Mark Leno plans to reintroduce SB 810 again this year. What is different this year is that we have a new crop of Legislators who we need to work with on this issue. We also have a new Governor and Executive Branch including several strong single payer supporters (Insurance Commissioner, Lt. Governor and others) who we plan to engage in this effort. On January 10th, Single Payer Now activists will join the CA Health Professional Student Association (CHPSA) for their annual lobby day and rally.

    This is a spectacular event, with hundreds of young medical students marching to the Capitol in their white jackets to urge our elected officials to support single payer. These are our future doctors, nurses, pharmacists, surgeons, etc. and they want to be health care providers, not insurance company slaves. Please join us for this important Kick-Off Event for our 2011 campaign to pass single payer in California. Let’s show our new legislators and Governor that we are strong, determined, and ready to win.

    From

  6. The cognitive dissonance I experience in listening to reports of the plans to repeal “Obamacare” results from my understanding that the health insurance and pharmaceutical industries have more to gain than to lose by keeping it in place. The mandate alone guarantees a big new pool to the insurance industry, and — thanks to the sellout on single-payer — with few of the cost-controls that the new system might have imposed.

    I heard Wendell Potter, former CIGNA exec turned muckraker, say as much in an interview recently.

    If the industry is against repeal, it won’t happen, no matter how much the Tea Party whines about it.

  7. My view of it exactly Ben and Don. The ball was fumbled away and the HMOs, etc have recovered it. Some say Obama and his crew got what they could, but I look at it as a wasted opportunity. It also makes me wonder who Obama really represents.

  8. Allow my to suggest something VERY radical: Why not run our healthcare system the way that we run our food industries?

    Seems to me that eating and healthcare are both pretty essential to our well-being. In the former we have kept the government pretty well confined to its proper role of preventing fraud [just weights & measures] and enforcing contracts [truth in advertising IE the stuff being sold is really what the label says it is]. The result is that we have an amazing system that deliveries the food we want at prices most can afford.

    In the case of healthcare we have moved away from this model to the European model of government control as clearly demonstrated by all the suggestion and programs mentioned above.

    Why not get the government & business interests [who have been in bed with the government since WWII] OUT of healthcare and let people buy what they think they need from among many competing interests, just like we do with the grocery stores?

    John

    1. Ben,

      You avoided the key question: Why is primary food-delivery for profit working well and yet you state that primary healthcare for profit would not?

      John

      1. Mr. Stoos,

        I enjoy your position as “self-appointed right-wing foil” on this blog; but when you insult our intelligence by dipping your hand into the logical fallacies kitbag, not so much.

        The first logical fallacy you use here is Ignoring a Common Cause. You state that “primary food-delivery is working well” and attribute that solely to the profit motive. But that’s not the fallacy I want to discuss in this particular comment.

        Your other logical fallacy is the classic Burden of Proof. Since you’re the one making the case, how about you prove to the audience that delivering wholesome and reasonably-priced food is the same as delivering quality and affordable health care.

        For this discussion to go any further, you will need come up with at least 4 different aspects of the food delivery system is the same as the health care delivery system.

        Oh, and none of those ways can be “because they’re both used by human beings.”

        Michael A.

      2. Michael,

        Let me see if I can figure this out:

        1) If I don’t eat I die and if I don’t treat a serious infection I die. [Both still happen in many third-world nations.]

        2) If I only have a narrow selection of foods to eat I will be malnourished and if I can only see certain specialists I will be in poor health.

        3) If I cannot afford to buy food I will go hungry and if I cannot afford healthcare I will be in poor health.

        4) If the qualify of food I can get my hands on is poor I could die and if I am treated by quacks I could die.

        Sure seems to me that there is no logical fallacy present here: Both are essential to our good life.

        The real question remains, why do we need SO much government in the one area and only minimal government in the other?

        John

        PS: I am not saying there are no problems with our food delivery, but I can make the case that most of them are because of too much government and not the lack thereof.

    2. Right on, Ben. This is precisely the successful model in most European countries, where — by the way — the national cost for health care per capita is about half what it is here in the US, and with better overall outcomes.

      But of course … “we’re the greatest!”

  9. Our present food industry and health industries are already in a mutually beneficial relationship. Our food industry is already financially supported by our government, so why fear the govenment in the medical industry? The HMOs are for profit and look where that has gotten us. Our ranking worldwide isn’t impressive. Are profits more important than our health?

  10. By the way John, I bet you didn’t hear that Texass is as bad off budgetarily speaking as California…talking about throwing Medicare out of the state. I thought all that oily, greasy business, water and air was supposed to “be good” for Perry and his state…Kate Hancock

  11. Kate,

    You are right, I did NOT know that Texas has a 20% budget deficit, a ten billion deficit for their unemployment payments and a half a trillion in unfunded pension liabilities.

    Glad you shed some light on this: Care to share any facts?

    John

    1. Yes John, fact is: the oil industry and wall street thugs have set about raping Texas too–even though she ain’t near as purty as her sister state California. They get to experience their vileness in filthy air and filthy water as a bonus. Rick Perry and his ilk are a southern fried mess of corruption without nary a senator or congressman to help em out. And the poor rubes get four more years of political texan “hari-kari Perry” slapping the feds with one hand and begging poor mouth with the other. That smells like hyp-o-crite in the morning in Beaumont…Kate Hancock…did I splain it clear enuf fer ya, Stoosy?

  12. Tea Party Republicans are also attempting Grand Theft from the retirement plans of teachers. Good luck finding new recruits to fall for, “but you get a generous pension.” Read a few of the comments in The Union.

  13. John,
    I have to challenge your food and health care analogy. Or maybe it is a good one.

    John when is the last time you went to a grocery store in an poor inner city neighborhood? It is very difficult to find a full size grocery store because those neighborhoods don’t have big money so fast food, 7/11’s, and minimarts are the only option within a reasonable distance.

    So once again affordability and accessibility are the key elements of the issue.

    One difference between the two examples is I can grow food but cannot treat myself for cancer or repair a torn ACL.

    John if you can’t see the difference there is little reason to discuss this any further because it will be a dialogue of conflicting ideology and worldviews.

    Health Care is a Human Right

    1. Thanks Ben.

      You saved me from having to reply to John. Those were exactly the examples I was going to bring up.

      M.

  14. Ben & Michael,

    So is eating more or less a human right than healthcare? Do we all have the right to steak dinners at Morton’s at least twice a week? If not then what level of eating is my right and by extension what level of healthcare is my rightful share?

    Ben, you can grow your own food, but if we all still grew our own food there would be a lot of starving people in the world and very hungry people in our nation. It has been the same Christian principles of free-market economies and true compassion that have given us an abundance of both. Just go back and study the first year at the Plymouth colony to see how hungry folks got without the market principle of private property and profit and look to much of Africa today to see the hungry that result from lack of compassion. A civilized society needs both and we should strive for both.

    I happen to live in the Inner City so I know first hand how difficult it is to operate here: For individual families as well as super market chains. There is always a cost to bad behavior.

    A few years ago they put a Blockbuster right down the street from my house which was very convenient and it even had a drop box. Sadly there were a lot of thefts from the box and so it had to be taken down after just a few months. Is that because the executives at Blockbuster don’t like my neighborhood or because there are bad people here who did bad things?

    The bottom-line is that you still have not addressed the basic question: If we don’t need the government to delivery our food in abundance at reasonable prices why do we need them to do so with healthcare?

    If you want the answer to why healthcare is so expensive today, this is the right question to be asking.

    John

    1. John,

      Here are some differences between food and health markets.

      Most of medicine is about selling “information,” and to drugs which are potentially dangerous. Both tend toward monopoly with or without government intervention. Medicine is also about prevention of potential bad things, which are not dealt with well in a market focused by consumption.

      Most of food is about things that are pleasurable, and dealt with better (though not perfectly) in relatively free markets.

      I would also note that when food becomes short, government inevitably steps in with famine relief. This goes back at least to the time of the well-known socialist Moses, who daily had to deal with the distribution of famine relief (manna) when the markets of Sinai failed!

      I like free markets where they are appropriate and efficient.

      But there are also somethings where government regulation, sometimes clumsy and heavy-handed, are appropriate too. Places where there is not “perfect information” is one of them. Health care in the US is one area which countries which have nationalized health care seem to do better than the US in terms of cost per patient, and overall health of the population.

      1. Tony,

        I was not arguing that they are identical, just both essential. People love to throw out the line “healthcare is a right” which has no meaning without some context.

        As the link I provided demonstrates, even where the government has ventured into “helping” us better handle our food they end up subsidizing Happy Meals while suggesting that we eat more vegetables.

        Try to imagine the mess our food distribution system would be in if there was NO relationship between the cost of what I buy and what I had to pay. Like having my employer buy me a food policy for the local market so I can go in and get whatever I want to eat and only pay a small co-pay at the check stand.

        And since SR mentioned welfare, living in the inner city for almost 30 years we have seen the beginning of such nonsense: Many times my wife would watch someone using food stamps or a welfare card buying very expensive processed foods that we could not afford on our regular budget.

        John

    2. Actually, the government is pretty heavily involved in food production. It subsidizes production in many cases, and also provides a minimum subsidy to assist the poor – it’s called food stamps. This principle – of providing subsidies to ensure the poor have access to basic human needs like housing, food, and healthcare – is generally acknowledged as a primary characteristic of a civilized society.

  15. John,
    There are more starving people on the planet today than any other time in world history.

    No, people do not have the right to steak dinners at a restaurant twice a week. But people do have the right to access to health care if they need without having to go bankrupt. Over 1 million people will file for bankruptcy because of medical bills this year and 700 thousand of them will have health insurance. 45,000 people will die because they don’t have access to health care. These stats are immoral.

    If you live in the inner city then you understand my example first hand. Food like health care isn’t available to many people in poorer neighborhoods.

    1. Ben,

      Do you have a source on the statement that more people are starving today?

      I can assure you that there is no shortage of food in the inner-city: Mostly the wrong kind at prices that are too high, but there is plenty of food which is why the President’s wife is on the crusade she is on for healthier eating.

      John

      1. John,
        Ben is probably right in the sense that in absolute numbers, there is more hunger today then ever before–this is largely because there are more people. By the same token, there are also more people than ever who are not hungry, and overweight. This is a function of mass numbers, as much as deteriorating food distribution systems.

        Killing famines have in large part disappeared because of early famine warning systems, and the capacity of the world to deliver relief goods quickly via the World Food Program, USAID, etc. There is a debate in the relief community about the extent famine is induced by man-made causes/policies, or weather fluctuations. Both are right, I am afraid.

        Tony

      2. John,
        Nearly 7 billion people live on the planet and banking speculation along with climate change (severe floods and droughts) 16,000 children a day will die because of hunger related causes. This while all republicans and democrats fight for more tax breaks for millionaires and billionaires or more income inequality. Disgusting

        World hunger sources
        http://www.bread.org/hunger/global/

        http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm#Number_of_hungry_people_in_the_world

        http://www.oxfam.org/en/pressroom/pressrelease/2009-10-16/world-food-day

        “Mostly the wrong kind at prices that are too high, but there is plenty of food which is why the President’s wife is on the crusade she is on for healthier eating.”

        That is my point. Ho Ho’s and Twinkies are not food. High fructose corn syrup is not food. All this highly processed so called food doesn’t meet the bodies needs for nourishment.

    1. John,
      I agree it is the government who drives such nonsense. But disagree that the markets don’t play a huge role.

      Here comes the broken record again with this vicious cycle.

      Tax laws changed so big agriculture has more accumulated wealth= more lobbyists= increased subsidizes to big corn industry = donations from big corn industry to government officials and political parties who subsidize them along with more lobbyists= NAFTA gets passed= heavily subsidized US based corn now floods Mexico market putting local farmers out of business= more money for the big corn industry to lobby our government officials =undocumented workers flooding the US labor force driving down wages = more profits = more money to lobby our government

      and so on.

      Our government is controlled by big business and this is where the real grass roots part of the Tea Party will hopefully end up. Realizing our government takes its marching orders from big business and that is really where our anger should be focused. Removing the influence of big money out of our elections and then our government.

      If you want to reduce waste, unnecessary spending, and the size of the federal government we need to get this cancerous influence out our political arena.

      1. Ben,

        I think you and I are close on the major principal: Government should NOT play favorites. You list above is accurate and it begins with government giving a tax break.

        Folks often worry about the market because they the BIG guys will have monopolies: The reality is that you cannot have a monopoly without government interference.

        John

      2. Monopolies are created by the absence of Government because those who have the most money destroy competition. We have laws on the books to prevent monopolies from controlling our economy and ultimately our government but since Reagan the laws have not been enforced. At the same time the redistribution of wealth to the top 0.05% have created a government and economy for the extremely wealthy.

        In the 80’s we saw the Sherman Anti Trust Laws ignored, merger and acquisition era emerge, beginning of deregulation of banks, Top Marginal Tax Rates dropped by over 40%, taxes on the middle and lower income brackets raised, alternative energies removed from US interests, breaking of labor unions, ect…

        All of this set up what we have today, monopoly capitalism. The banking industry was a perfect example of how it works. The enormous fish had to eat up some medium fish to keep it going. What’s next, transnational banks taking over countries because of manufactured debt bombs? Oh yeah, that is already happening.

      3. Ben,

        This is an interesting debate because we both have the same goal, eliminating the unfair advantage of many corporate interests, but see the cause in exactly opposite ways.

        Let me try and get you to see my premise [no monopolies without government involvement] with a couple of examples: I can only buy my electricity from one utility: That is not because SMUD is better than all others but because the government says that I must. Here many argue such a monopoly is a good thing because we do not want several electric lines running into our neighborhoods, but it still took the government to make the monopoly happen. Whether there are any good monopolies is another debate.

        Again I would ask, can you cite a single example of a monopoly today that does not exist because of government mandates or arrangements?

        Next if we look at the past there is a different question: Can you think of any monopolies that existed without government BEFORE all the anti-trust laws were past in the 20th Century? Yes, I am talking about the days of the good old robber barons!

        The example that folks usually point to is the big oil companies, but there were more than one and the ones that grew huge, like Standard Oil did so by providing broad distribution of a great new product at lower and lower prices: Why was that a bad thing? If they had attempted to gouge people with higher prices, then they would have brought on more competition.

        Please understand that I agree with your assessment of most of the business scandals that we have today, but they exist because these men and/or companies figured out how to use the power of government for their own advantage and to eliminate their natural competitors.

        Again the government’s proper role in commerce is to prevent fraud and enforce contracts: Make sure people tell the truth and keep their promises. If they are tempted to play favorites with the force of law, even with good motives, the end result is what we see today with the various scandals you have outlined.

        John

        John

      4. John,
        I think we are on the same page on most of these issues but have totally different perceptions of cause and effect.

        Every single business in America has some kind of government connection. Legal companies can’t exist without going through government. Your example of Standard was an unusual one since Standard squashed out all competition and manipulated many different industries.

        Take your energy into our home example, without government we would be at the mercy of PG&E due to the fact only one set of wires is practical and maybe possible to enter into our homes. It was government that made it possible for electricity to be in every home. If you live in the country and were not independently wealthy no company would of hooked up power to the rural homes. Mail, Fire, Police, and Water are all in this same category.
        If we decide to live in a civil society it is the role of government to guarantee access to those things deemed necessities for living in our agreed society. It is the role of the government that it isn’t only the wealthy that can access education, health care, water, energy, legal protection or due process, fire protection, mail (its in the US Constitution), and so on.

      5. Ben,

        You have brought the discussion full circle when you leave off the need for food as something the government must insure that we have on your list [and yes I did notice that you threw education in there, but that is another whole discussion].

        Yes, the founders thought we needed the government to establish the postal system for the reasons that you outlined and California went with centralized utilities in the early part of the 20th Century for many of the same reasons. For the most part these were wise decisions and we enjoy many benefits from both.

        However, please notice that the “Post Office” and the old “MA Bell Phone Company” are the favorite whipping boys for inefficiencies and cost overruns.

        Fortunately we did not put super markets under government control and I am just asking us to think about whether it is really where we want to put health care?

        John

      6. It comes down to perception, mine is government is a much needed entity for us to have a civil society. Although created equal in the eyes of god all people are not treated equal on this earth.

        The FDA was put in place because a book called The Jungle pointed out the horrible conditions the meat packing industry was being run under. We as a society once informed demanded some protections.

        Advocating no government oversight on commerce is asking to go back snake oil salesman. Agriculture subsidies became a major issue during the Great Depression. This might be one of those policies that should of died out after the depression was over. But it didn’t and really wasn’t a major problem until the 1980’s and corporate farms started squeezing out family farms. Do you remember Farm Aid?
        http://www.time.com/time/arts/article/0,8599,2023006,00.html
        If you hang all the problems around the Obama administration because of his first two years in office you won’t have any problem hanging the destruction of family farms around President Reagan’s, right? The difference between the New Deal of FDR and the Raw Deal of Reagan is the new deal was for average Americans and the raw deal was for the wealthy.

        It was during the Reagan years we started down the path we find ourselves on today, corporatism. We have handed over the controls of our government and its functions to the private sector via political party contributions and lobbying efforts. Small business struggling, workers struggling, middle class vanishing, lower income brackets and poverty growing, and the very wealthy have never done better.

        For the record I voted for Obama but have been extremely disappointed and outspoken against many of his policies or continuing the Bush, Clinton, Bush, and Reagan policies. I hang much of our financial woes around the Clinton administration with his free trade agreements and pro wall st policies.

      7. Ben,

        I am sure we will continue this in some other posts, but for now I wanted to thank you for the lively debate.

        John

  16. Stoos hasn’t ever met an Archer Daniels Midland that he didn’t love…hey John, is this “Archer” a person or a Scalia defined “person” I’m talking about? Someone blew the dot’s off Herr Scalia’s dice a long time ago…what a fraud…Kate Hancock

    1. Kate,

      Since I would favor the elimination of all farm subsidies I doubt that Mr. Archer would want to make my acquaintance.

      It is NOT the government’s job to play favorites.

      John

  17. Ben Emery wrote:
    “That is my point. Ho Ho’s and Twinkies are not food. High fructose corn syrup is not food.”

    Let’s not get a little overzealous, here. What are Ho Ho’s & Twinkies?? Glass? Metal? They’re food just like Chocolate Cake (Bill Cosby routine). I wouldn’t recommend a strict diet of either, but com’on, they’re edible and, in practicality, quite enjoyable.

    Fructose is a common monosaccharide. In fact, all glucose gets changed to fructose in the early stages of glycolysis. I know the issues with diabetes, obesity, that most corn goes to corn syrup and how the lobby has cornered the market….. but that’s not a molecules fault. Basically fructose, is not dangerous. Don’t confuse biochemistry with behavior here.

    Lets change the point to “Ho Ho’s and Twinkies are not the most desirable food in a limited situation”.

    1. Well Chris you jumped in a little late and we were talking about nutrition and food. There are plenty of places to find total processed so called food but far too little places to find good affordable nutritious food in poorer neighborhoods. Just because we can eat it doesn’t make it food.

      here is an excerpt from
      http://www.healthyweightkids.org/fructoseformd.htm

      What is the Cause of this Leptin Resistance and Insulin Excess?

      The most significant change in our environment in the last 30 years, is the huge increase in fructose intake in our diets. Sucrose (table sugar) is 50% fructose, and the very widely used “high fructose corn syrup” is a major ingredient in practically all processed foods (read the labels and you will see it!). Kids are drinking tons of soft drinks and fruit juice (very high in fructose). Most soft drinks are loaded with high fructose corn syrup.

      Fructose does not suppress ghrelin (the hunger hormone), so kids keep eating and drinking more of it without satiety. It is absorbed in the intestine without insulin regulation and is converted to fructose-1-phosphate in the liver. This floods the glycolytic pathway producing excess acetyl-CoA that cannot be handled by the Kreb Cycle, and results in build-up of free fatty acids, VLDL lipoproteins and triglycerides which enter the bloodstream. In addition to adverse effects on the endothelium by all three substances, free fatty acids promote insulin resistance, and insulin excess. The triglycerides block leptin from crossing the blood-brain barrier. This starts the vicious cycle of leptin resistance, increased parasympathetic function and further secretion of excess insulin.

      1. Ben,

        Once again I think we are in agreement, but where did all of the subsidized advantages for corn syrup come from? The government playing favorites.

        John

      2. They came from a corrupted politician who had to return campaign favors, I know you want me to say our government which is true. But here is where I think we might part, I don’t think government is bad. We get bad government when we send people to represent us who don’t believe in good government so they govern the only way they know how, poorly.

        John, I think we are on the same page on many issues with slight differences.

        When I withdrew my consent to be apart of the two major parties it was a toss up between Libertarian and Green. Surprising to most people the two parties agree on many core philosophies and issues but I grew up with a very ethnically diverse set of friends and saw/ experienced first hand overt discrimination. This is where I believe libertarians fall short on their idea’s. Experiencing this I am very socially conscience. That being said I grew up playing and working on our relatives farms in Yuba City, Sutter, and Live Oak. They were almost entirely party line outspoken republicans.

  18. All Glucose gets changed to Fructose? I thought glycosis was primarily the conversion of glucose into pyruvates. Pyruvates than form ATP and NADH. Unfortunately, some peoples choices in food lead to diabetes, heart disease, obesity, etc.. We all end up paying for those choices.

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